Provider Demographics
NPI:1386612901
Name:MAIERS, TIMOTHY J (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:MAIERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 JOHN F KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3800
Mailing Address - Country:US
Mailing Address - Phone:563-556-8332
Mailing Address - Fax:563-556-8334
Practice Address - Street 1:1900 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3800
Practice Address - Country:US
Practice Address - Phone:563-556-8332
Practice Address - Fax:563-556-8334
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36154207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL438118966Medicaid
WI34654200Medicaid
IA0462390Medicaid
IL438118966Medicaid
IAI15444Medicare PIN